<?php
include_once("./util/client_ip_recorder.php");
?>
<p align="center"><span id="form-msg"></span></p>
<div id="comment-entry" class="center-holder">
<script type="text/javascript">
 var RecaptchaOptions = {
    theme : 'blackglass'
 };
 </script><form action="<?php echo $config_file['web_root']?>/php/datahandling/<?php echo $url?>" method="post" onsubmit="AjaxFormPost.send(this,<?php echo $callback?>); return false;">
<input type="hidden" name="client_ip" value="<?php echo getClientIP()?>"/>
<table id="form-table" border="0" align="center" cellspacing="0" cellpadding="0">
	<tr><td>&nbsp;</td><td><span class="form-field">Name [Required, max 100 charecters]:<br><input class="textbox" name="yourname" max-length="100" size="50"></span></td></tr>
